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Predictors of Early and Late Target Lesion Revascularization after Drug‐Eluting Stent Implantation

Predictors of Early and Late Target Lesion Revascularization after Drug‐Eluting Stent Implantation Introduction Recent studies have suggested the existence of a late catch‐up phenomenon after drug‐eluting stent (DES) implantation. The aim of this study is to identify predictors of early (≤1 year) and late (>1 year) target lesion revascularization (TLR) in DESs. Methods The COACT (CathOlic medical center percutAneous Coronary inTervention) registry was designed to evaluate the clinical outcomes after DES implantation. Data from 9,127 consecutive patients were reviewed, all of whom underwent percutaneous coronary intervention (PCI) with DES between January 2004 and December 2009, including 8,126 patients who received PCI with homogenous DES. Results During a median follow‐up period of 24 months (interquartile range, 11–41), the cumulative incidences of early and late TLR were 4.7% (95% confidence interval (CI), 4.2–5.1) and 3.3% (95% CI, 2.9–3.7). Independent predictors of early TLR were multivessel disease (odds ratio (OR) 1.637; 95% CI 1.241–2.158, P < 0.001) and stent diameter (OR 0.614; 95% CI 0.437–0.862, P = 0.005). Independent predictors of late TLR were stent diameter (OR 0.567; 95% CI 0.367–0.875, P = 0.010), insulin‐dependent diabetes mellitus (OR 2.235; 95% CI 1.314–3.802, P = 0.003), first‐generation DES (OR 5.104; 95% CI 2.744–9.492, P < 0.001), and elevated levels of high‐sensitivity C‐reactive protein at follow‐up coronary angiography >2 mg/dL (OR 1.616; 95% CI 1.173–2.226, P = 0.003). Conclusions Although multivessel disease and stent diameter were associated with early TLR, late TLR was more associated with clinical comorbidities including insulin‐dependent diabetes and procedural factors like the generation of the stent used and stent diameter. The risk factors for TLR may be markedly different at different time points during TLR. (J Interven Cardiol 2013;26:137–144) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Interventional Cardiology Wiley

Predictors of Early and Late Target Lesion Revascularization after Drug‐Eluting Stent Implantation

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References (26)

Publisher
Wiley
Copyright
© 2012 Wiley Periodicals, Inc.
ISSN
0896-4327
eISSN
1540-8183
DOI
10.1111/joic.12001
pmid
23163343
Publisher site
See Article on Publisher Site

Abstract

Introduction Recent studies have suggested the existence of a late catch‐up phenomenon after drug‐eluting stent (DES) implantation. The aim of this study is to identify predictors of early (≤1 year) and late (>1 year) target lesion revascularization (TLR) in DESs. Methods The COACT (CathOlic medical center percutAneous Coronary inTervention) registry was designed to evaluate the clinical outcomes after DES implantation. Data from 9,127 consecutive patients were reviewed, all of whom underwent percutaneous coronary intervention (PCI) with DES between January 2004 and December 2009, including 8,126 patients who received PCI with homogenous DES. Results During a median follow‐up period of 24 months (interquartile range, 11–41), the cumulative incidences of early and late TLR were 4.7% (95% confidence interval (CI), 4.2–5.1) and 3.3% (95% CI, 2.9–3.7). Independent predictors of early TLR were multivessel disease (odds ratio (OR) 1.637; 95% CI 1.241–2.158, P < 0.001) and stent diameter (OR 0.614; 95% CI 0.437–0.862, P = 0.005). Independent predictors of late TLR were stent diameter (OR 0.567; 95% CI 0.367–0.875, P = 0.010), insulin‐dependent diabetes mellitus (OR 2.235; 95% CI 1.314–3.802, P = 0.003), first‐generation DES (OR 5.104; 95% CI 2.744–9.492, P < 0.001), and elevated levels of high‐sensitivity C‐reactive protein at follow‐up coronary angiography >2 mg/dL (OR 1.616; 95% CI 1.173–2.226, P = 0.003). Conclusions Although multivessel disease and stent diameter were associated with early TLR, late TLR was more associated with clinical comorbidities including insulin‐dependent diabetes and procedural factors like the generation of the stent used and stent diameter. The risk factors for TLR may be markedly different at different time points during TLR. (J Interven Cardiol 2013;26:137–144)

Journal

Journal of Interventional Cardiology – Wiley

Published: Apr 1, 2013

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